Men's knowledge of their own fertility: a population-based survey examining the awareness of factors that are associated with male infertility.

STUDY QUESTION: How knowledgeable are men about the medical, environmental and psychological factors that are associated with male infertility?

SUMMARY ANSWER: Men, across most demographic groups, have limited knowledge of the various factors that are associated with male infertility.

WHAT IS KNOWN ALREADY: Few surveys have focused on men's knowledge of their own fertility. Studies of both men and women have found that men are comparatively less knowledgeable about issues of fertility and reproductive health.

STUDY DESIGN, SIZE, DURATION: A regionally representative sample of Canadian men completed a web-based survey of male fertility and reproductive health, over a 2-month period in 2015.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Men, aged 18-50 years, were recruited for the study. There were 701 male participants, with a mean age of 34.1 years. Each participant was asked to identify factors associated with male infertility; fertility knowledge was assessed through two open-ended questions and a comprehensive list of risk factors and attendant health issues.

MAIN RESULTS AND THE ROLE OF CHANCE: Men were only able to identify 51% of the risk factors and 45% of the health issues associated with male infertility. Men were most aware of the modifiable risk factors for infertility (e.g. sexually transmitted infections, smoking cigarettes), relative to their knowledge of fixed risk factors (e.g. delayed puberty, size of testicles) and the attendant health issues (e.g. cardiovascular disease, diabetes). The overall level of fertility knowledge did not vary by most demographic characteristics (e.g. age, education, employment, income), though men from ethnic minority groups displayed moderately greater awareness. Additionally, younger men, those with lower incomes and those who had no desire to have future biological children were more likely to identify themselves as unaware of associations with infertility in the open-ended questions. Self-reported knowledge was significantly associated with higher overall knowledge scores. More than half of the sample expressed an interest in obtaining information about male fertility and reproductive health, with the majority of these men indicating that medical professionals and online sources were their preferred methods for receiving information.

LIMITATIONS, REASONS FOR CAUTION: Participants were self-selected and required to have Internet access in order to participate. This may affect the generalizability of results.

WIDER IMPLICATIONS OF THE FINDINGS: Previous studies of fertility knowledge have either omitted men from their samples or when men have been included, they were asked about general fertility or women's fertility. This is the first large-scale survey that focuses solely on men's knowledge of male fertility. Insight into the areas where men's knowledge may be lacking can inform strategies for disseminating fertility-related information and improving men's fertility awareness. Public health initiatives should tailor campaigns to educate men about the lesser known associations with male infertility, particularly those that are most prevalent and preventable through lifestyle modification.

STUDY FUNDING/COMPETING INTERESTS: The study was funded by a grant from CIHR TE1-138296. No competing interests.